透析と腎臓移植を受けた患者のうち,股関節骨折のリスク
Adrianne M Ball1, Daniel L Gillen, Donald Sherrard
1Division of Nephrology, School of Medicine, University of Washington, Seattle, Wash, USA.
JAMA
|December 17, 2002
まとめ
腎臓移植を受けた患者は,当初は透析患者よりもヒップ骨折のリスクが高くなりますが,このリスクは移植後630日ほどで等しくなります. 移植前に長期にわたる透析は,骨折のリスクを高めます.
科学分野:
- ネフロロジーはネフロロジーを用います.
- 整形外科 整形外科 整形外科
- エピデミオロジー エピデミオロジー
背景:
- 末期腎疾患 (ESRD) は,股関節骨折のリスクを大幅に上昇させます.
- 腎臓移植と透析の対照的な影響が,股関節骨折のリスクに及ぼす影響は,依然として不明である.
研究 の 目的:
- 腎臓移植を受けた患者が,透析を続ける患者と比較して,股関節骨折のリスクが高いかどうかを調査する.
主な方法:
- コーホート研究では,米国の腎臓移植の待機リスト (1990年-1999年) に登録された101039人のESRD患者を分析した.
- ヒップ骨折は,メディケアクレームデータを用いて特定されました.
- フォローアップデータは314,767人年を超えた.
主要な成果:
- 股関節骨折の発生率は,透析患者で1000患者年当たり2.9%,移植を受けた患者で1000患者年当たり3.3であった.
- 最初,移植は,透析と比較して,骨骨折の相対リスク (RR) が1.34倍増加したとの関連がありました.
- このRRは毎月1%減少し,移植後の約630日位に等しくなりました. 移植前の長期にわたる透析によりリスクが増加しました.
結論:
- 腎臓移植を受けた患者は,移植後の最初の1〜3年以内に,透析患者よりもヒップ骨折のリスクが高くなります.
- リスクの均衡は,移植後約630日後に起こります.
- 移植前の透析の期間は,移植後の骨折リスクの要因である.
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